反复呼吸道感染患儿病原菌分布与耐药性分析

Distribution and Drug Resistance of Pathogens in Children with Recurrent Respiratory Tract Infection

目的对反复呼吸道感染患儿病原菌分布与耐药性进行探讨分析。方法于本院2015年1月至2017年1月期间收治的反复呼吸道感染患儿中选取200例作为本次研究的观察对象,对200例患儿提取鼻咽分泌物样本进行病原菌培养及鉴定,分析病原菌的分布情况及患儿耐药性。结果 200例患儿共检出1126株病原菌,817株(72.56%)革兰阴性菌及309株(27.44%)革兰阳性菌;革兰阴性菌主要包括128株(11.37%)大肠埃希菌、151株(13.41%)铜绿假单胞菌、352株(31.26%)流感嗜血杆菌等;革兰阳性菌主要包括58株(5.15%)肺炎链球菌、165株(14.65%)金黄色葡萄球菌等。金黄色葡萄球菌、肺炎链球菌对青霉素有较高的耐药性,金黄色葡萄球菌对阿莫西林、氨苄西林、氟氯西林及青霉素均有较高耐药性,肺炎链球菌对苯唑西林有较高耐药性,大肠埃希菌对头孢呋辛有着较高的耐药性,铜绿假单胞菌对头孢呋辛和氨曲南有较高的耐药性。结论革兰阴性杆菌是反复呼吸道患儿主要的感染病原菌,临床应加强病原菌耐药性质的检测,同时加强耐药机制的研究,以提高抗菌药物在反复呼吸道感染患儿治疗中合理使用。

Objective To investigate the distribution and drug resistance of pathogens in children with recurrent respiratory tract infection. Methods In our hospital from January 2015 to January 2017, 200 cases of recurrent respiratory tract infections were selected as the object of this study. The samples of nasopharyngeal secretion were extracted from 200 children, and the pathogenic bacteria were cultured and identified, the distribution of pathogens and drug resistance in children were analyzed. Results 1126 strains of pathogenic bacteria were found in 200 children, including 817 strains(72.56 %), gram negative bacteria and 309(27.44 %) gram positive bacteria, gram negative bacteria mainly included 128 strains(11.37 %), Escherichia coli, 151 strains(13.41 %), Pseudomonas aeruginosa, and 352 strains(31.26 %) Haemophilus influenzae; Gram positive bacteria mainly included 58 strains(5.15%), Streptococcus pneumoniae, 165 strains(14.65%), Staphylococcus aureus and so on. Staphylococcus aureus, Streptococcus pneumoniae is highly resistant to penicillin,Staphylococcus aureus versus amoxicillin, Ampicillin, Methicillin resistant and penicillin were highly resistant,Streptococcus pneumoniae is highly resistant to oxacillin, Escherichia coli had a higher resistance to cefuroxime,Drug resistance of Pseudomonas aeruginosa to have higher cefuroxime and aztreonam. Conclusion Gram negative bacilli are the main pathogenic bacteria in children with recurrent respiratory tract diseases, clinical examination should strengthen the detection of drug resistance of pathogenic bacteria. At the same time, the mechanism of drug resistance was enhanced to improve the rational use of antibiotics in the treatment of children with recurrent respiratory tract infection.